Diabetes mellitus after injury in burn and non-burned patients: A population based retrospective cohort study.
Burns
; 44(3): 566-572, 2018 05.
Article
en En
| MEDLINE
| ID: mdl-29306596
ABSTRACT
OBJECTIVE:
To compare hospitalisations for diabetes mellitus (DM) after injury experienced by burn patients, non-burn trauma patients and people with no record of injury admission, adjusting for socio-demographic, health and injury factors.METHODS:
Linked hospital and death data for a burn patient cohort (n=30,997) in Western Australia during the period 1980-2012 and two age and gender frequency matched comparison cohorts non-burn trauma patients (n=28,647); non-injured people (n=123,399). The number of DM admissions and length of stay were used as outcome measures. Multivariate negative binomial regression was used to derive adjusted incidence rate ratios and 95% confidence intervals (IRR, 95%CI) for overall post-injury DM admission rates. Multivariate Cox regression models and hazard ratios (HR) were used to examine time to first DM admission and incident admission rates after injury discharge.RESULTS:
The burn cohort (IRR, 95% 2.21, 1.80-2.72) and other non-burn trauma cohort (IRR, 95%CI 1.63, 1.24-2.14) experienced significantly higher post-discharge admission rates for DM than non-injured people. Compared with the non-burn trauma cohort, the burn cohort experienced a higher rate of post-discharge DM admissions (IRR, 95%CI 1.40, 1.07-1.84). First-time DM admissions were significantly higher during first 5-years after-injury for the burn cohort compared with the non-burn trauma cohort (HR, 95%CI 2.00, 1.31-3.05) and non-injured cohort (HR, 95%CI 1.96, 1.46-2.64); no difference was found >5years (burn vs. non-burn trauma HR, 95%CI 0.88, 0.70-1.12; burn vs non-injured 95%CI 1.08 0.82-1.41). No significant difference was found when comparing the non-burn trauma and non-injured cohorts (0-5 years HR, 95%CI 1.03, 0.71-1.48; >5years HR. 95%CI 1.11, 0.93-1.33).CONCLUSIONS:
Burn and non-burn trauma patients experienced elevated rates of DM admissions after injury compared to the non-injured cohort over the duration of the study. While burn patients were at increased risk of incident DM admissions during the first 5-years after the injury this was not the case for non-burn trauma patients. Sub-group analyses showed elevated risk in both adult and pediatric patients in the burn and non-burn trauma. Detailed clinical data are required to help understand the underlying pathogenic pathways triggered by burn and non-burn trauma. This study identified treatment needs for patients after burn and non-burn trauma for a prolonged period after discharge.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Quemaduras
/
Diabetes Mellitus Tipo 2
/
Hospitalización
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Oceania
Idioma:
En
Revista:
Burns
Asunto de la revista:
TRAUMATOLOGIA
Año:
2018
Tipo del documento:
Article